The invention relates to a retractor. In particular the invention relates to a retractor for retracting the margins of an incision or a natural bodily orifice to provide maximum exposure of an organ or body structures for examination and/or access for surgical procedures, while also providing protection for the exposed sides of the incised tissue.
Various retractors are known. However in general known retractors are difficult and cumbersome to use, and/or are relatively expensive. In addition known retractors are limited to use with a particular size of incision and a particular patient anatomy.
This invention is directed towards providing an improved wound retractor which will overcome at least some of these problems, and in addition provide a means of wound protection during a surgical procedure.
According to the invention there is provided a surgical wound retractor comprising:
a distal anchoring member for insertion into a wound opening;
a connecting means having an inner wound engaging portion and an outer portion, the wound engaging portion being mounted to the distal anchoring member, the connecting means having an insertion configuration in which the inner wound engaging portion has a reduced radial dimension and a retracting configuration;
an external guide means for the outer portion of the connecting means;
the external guide means being movable relative to the connecting means to shorten the axial extent of the connecting means and thereby bias the wound engaging portion of the connecting member into the retracting configuration to retract the wound opening laterally; and
external anchoring means for anchoring the connecting means to maintain retraction of the opening.
In one preferred embodiment of the invention at least the inner wound engaging portion of the connecting means comprises a sleeve for extending around the wound opening to protect the opening.
In one embodiment the outer portion of the connecting means comprises a sleeve extension of the inner wound engaging portion of the connecting means.
Preferably the connecting means comprises a generally cylindrical sleeve.
In a preferred embodiment the guide means comprises an annular ring means. The annular ring means preferably comprises inner and outer ring parts between which the connecting means is led. In a preferred embodiment the outer ring part includes the anchor means for anchoring the connecting means. In one arrangement the anchor means comprises anchor formations on the outer ring to which the connecting means is attached on retraction of the opening.
Preferably the inner ring means defines a projection for location in a complementary recess of the outer ring with the connecting means located therebetween.
In one embodiment the inner ring is a relatively loose fit in the recess of the outer ring part.
Preferably at least portion of one of the ring parts is movable from a rest position in which the connecting member is substantially clamped between the ring parts to a release position in which at least portion of the connecting member is movable relative to the rig parts. Ideally only portion of the connecting member is movable relative to the ring parts in the release position.
In another embodiment the inner ring is a relatively tight fit in the outer ring part to grip the connecting member therebetween.
In one aspect of the invention the outer ring part comprises a plurality of interconnected segments which are independently movable to facilitate localised release of the connecting member for adjusting of the retraction force applied at the opening. The ring part or segment thereof is preferably manually manipulable between the clamped rest position and the release position.
In one embodiment of the invention the connecting means includes a proximal reinforcing means for engagement with the external anchoring means. Ideally the proximal reinforcing means is a proximal ring.
Preferably the distal anchoring means is of resilient material. Typically the distal anchoring means is an O-ring.
Preferably at least an outer surface of the guide means which engages with the connecting means is of a material with a low coefficient of friction such as polytetrafluroethylene.
In a particularly preferred embodiment the retractor includes a platform for attachment of another device to the retractor.
In an especially preferred arrangement one of the ring parts defines a platform for attachment of another device to the retractor.
In another aspect the invention provides a method for retracting a wound opening using a surgical wound retractor comprising a distal anchoring member, a connecting means having a wound engaging portion mounted to the distal anchoring member and an outer portion, an external guide means for the outer portion of the connecting means and an external anchoring means, the method comprising the steps:
positioning the distal anchoring member to be retained inside a wound opening with the connecting means extending outwardly therefrom through the opening;
moving the external guide means relative to die outer portion of the connecting means to shorten the axial extent of the connecting means and thereby bias the wound engaging portion into a retracting configuration to retract the wound opening; and
anchoring the connecting means to maintain retraction of the wound opening.
Preferably the method includes the steps of moving the external guide means relative to the outer portion of the connecting means to partially retract the wound opening, gripping the outer portion of the connecting means and pulling it relative to the guide means to filly retract the wound opening.
In one embodiment the method includes the steps of:
(a) gripping a local section of the outer portion of the connecting means while the remaining section of the outer portion of the connecting means is anchored,
(b) pulling the local section to increase the retraction at a local area of the wound opening, and
(c) anchoring the local section of the connecting means.
Ideally the method includes repeating steps (a) to (c) for other local sections of the outer portion of the connecting means.